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| Why are newborns more susceptible to communicable disease? | Infant’s immune system is not fully mature at birth & protection through immunization is incomplete. Passive immunity decreases in the newborn in the months after birth.
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| Define characteristics of the feverish vs the toxic child. | Feverish – irritable & restless, sleep fitfully, and have nonspecific muscular pain
Toxic – lethargy, poor perfusion, hypo/hyperventilation, cyanosis
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| How should the nurse react to a parent who refuses immunizations for a child? | Document the informed refusal;Explain risk & benefits, common local reactions by using VIS info.
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| Varicella (chickenpox) | acute onset of mild fever, malaise, anorexia, headache, mild abdominal pain, and irritability. Macular rash for a few hours that progresses to pruritic vesicular lesions for 1-5 days, and then to crusts. Crusts may remain for 1-3 weeks.
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| Erythema infectiosum | begins as a mild illness followed by rash in 7-10 days. A fiery red rash often appears on cheeks giving a “slapped face” appearance. A lace-like symmetric, erythematosus, maculopapular rash appears on trunk & spreads to extremities
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| Roseola | sudden onset fever > 39.5 *C (103 *F) for 3-7 days, during which child does not appear toxic (normal appetite & behavior) and has no rash or disease-specific signs. An erythematous maculopapular rash appears after fever resolves & lasts hours to days.
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| Rubella (German measles) | An erythematous maculopapular rash appears firs on face & becomes generalized within 24 hr. Other signs include low grade fever & lymhadenopathy, conjunctivitis, or Forchheimer spots (discrete erythematous lesions on soft palate).
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| Congenital rubella syndrome | growth retardation, radiolucent bone disease, hepatosplenomegaly, thrombocytopenia, and purpuric skin lesions (giving “blueberry muffin” appearance).
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| Which guage needle/length should be used to administer immunizations to a 6 month old infant? | 1-1 1/2 inch needle for anterior thigh, fine gauge (25-21).
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| Review the immunization goals and recommendations of Health People 2020.(1st 2) | Achieve & maintain effective vaccination coverage levels for universally recommended vaccines among young children;Increase the proportion of children aged 19-35 months who receive recommended vaccines;
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| immunization goals and recommendations of Health People 2020 (2nd part) | Maintain vaccination coverage levels for children in kindergarten;Increase routine vaccination coverage levels for adolescents with vaccines recommended by Advisory Committee on Immunization Practices.
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| What discharge instructions should be provided to a parent who is to give an oral antibiotic to a child diagnosed with an infection? | Give all dosages as prescribed for full number of days ordered;
Ensure parents know how to administer antibiotics (r/t food);
Don’t share antibiotics with any other family members
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| What is the Nurse’s responsibility for observation and reporting of bioterrorism? What observations would make the RN suspect an attack has been made? | maintain high level of suspicion when numerous individuals with similar signs & symptoms are present in school or seek care in health care facility; initiate infection control, isolation, support
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| How should a school aged child with otitis media be treated for a fever? | Acetaminophen & ibuprofen are preferred antipyretics for children; remove unnecessary clothing, careful continued monitoring of temperature progression. Identify clear fluids child prefers to drink & encourage extra intake of fluids.
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| Early localized disease (ELD) | erythema migrans, a painless expanding single annular red rash that may develop central clearing; 5-15 cm in diameter. Rash may look like a bruisein dark-skinned patients. May have fever, body aches, headache & malaise
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| Early disseminated disease (EDD) | in 3-10 weeks after tick bite, multiple smaller erythema migrans lesions, fever, headache, neck pain, malaise, conjunctivitis, enlarged lymph nodes, and cranial nerve palsies may develop. Carditis & meningitis can occur.
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| Late disseminated disease (LDD) | in 2-12 months Lyme arthritis develops, commonly in knee, with pain, swelling & effusion. Child may develop encephalitis, polyneuritis & memory problems.
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| What symptoms in an infant should alert a parent to call their health care provider immediately because their child might have an infectious disease? | child has fever over 40*C(104*F) & crying inconsolably, difficult to awaken, stiff neck, purple spots on skin, difficulty breathing, unable to swallow, convulsions
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| Which immunizations are provided during the appointments for children from 2mos to 1 year? | Rotavirus, Dtap, haemophillus influenza type B, pneumococcal, inactivated poliovirus, hepatitis B, influenz (starting @ 6 months)
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